CYMBALTA

Thursday, February 24, 2011

New Zealand Prozac Case File - Toran Henry

First off, I'd like you to read the first few paragraphs...then close your eyes and take in what you have just read.

Your life is pretty good, you have a nice house, a car and a great job, you aren't rich but you get by. Your only child is a teenager, he's having a bit of trouble at school but hey ho didn't we all.

You are out shopping in a supermarket, the groceries from your cart are bagged and loaded into your car for your drive home, a 20 minute drive.

You call your only child and ask if he needs anything. "No Mom, I'm okay thanks"

As you pull up to your driveway to park your car into your garage something seems wrong. Why is the garage door open, what is that shadow in the middle?

You get closer and you see a garden hose, someone is hanging from it.

It's your son.

Now close your eyes...

What would you do in this situation? What would your instinct be?

For Maria Bradshaw this was a reality. Her 17 year old son, Toran, was that shadow.

Toran Henry's mother, Maria Bradshaw

Maria screamed and ran to Toran, he was already dead but she didn't know it. She flung her arms around his body and tried lifting him to take the pressure off the noose that was wrapped around his neck. With all her strength she screamed for help and tried desperately to lift her son until eventually the strength left her. Toran's neck met the noose once again with a thud, a thud that will live long in the memory for Maria.

Why am I writing about suicide in such a graphic manner? Because I have sat for hours with Maria Bradshaw and listened to her story. I have sat and watched tears flow and her whole body shake as she relived the moment we, as parents, all dread.

This is part I of Maria's story...

Part I - Toran Henry

Toran was born at born at 11.54am on 13 May 1990, from the age of just 14 months, Maria, his mom, seperated from her partner and raised Toran single handedly.

A young Toran Henry

It became apparent early on in Toran's life that he was gifted and had an interest in all things mechanical. By the age of 14 he was building computer servers and studied quantum mechanics and astrophysics in his spare time.

It wasn't all work and studying for Toran, he had a large group of friends that he socialised with and his charm made him one of the popular teens within his circle of friends.

Toran enjoys a day at the zoo

At 16, like most boys of his age, Toran became interested in girls and was devastated at the break up of his first serious relationship. A cry for help saw Toran inflict cuts on himself. Concerned, his mom took him to the emergency department of a local hospital where she was told that the self inflicted cuts were mere “scratches” by the registrar who attended him. The registrar added that Toran was a high functioning teenager who was experiencing an ‘expected and transient response to a stressful life event.’ He referred Toran to youth mental health services for a fuller assessment and counselling.

The adolescent psychiatrist, Kaye Brightly, who was assigned to Toran, couldn't wait, it appears, getting Toran on to psychiatric medication.

His records, shown to me by his mother, show that Brightly:

Medicated him immediately without conducting a thorough assessment

Made no diagnosis of depression or any other mental disorder

Failed to monitor his reaction to medication

Ignored Toran and Maria’s repeated reports that he was suffering the sideeffects of medication which are known pre-cursors of suicide

Failed to treat general medical conditions revealed in blood tests undertaken by his GP at his mother’s request

Failed to check that concurrent use of an SSRI and Toran’s migraine medication was safe (it is not, and can cause potentially fatal serotonin syndrome).

Provided Toran with a pamphlet advising that SSRIs protect against suicide and that it is safe to overdose on Prozac. (This pamphlet has been withdrawn after the Ministry of Health advised Waitemata District Health Board [WDHB] that overdosing on Prozac can be fatal).

Took no action when she discovered Toran had used fluoxetine as a recreational drug and self harmed several hours later.

In error provided Toran with prescriptions for 6 months worth of Prozac in a 24 day period.

Increased his dose of medication in response to Toran’s worsening moods and behaviours.

During his period of 'care', Toran showed increasing signs of aggression, anger and agitation and engaged in high risk behaviours. He dropped out of school and began drinking heavily. His relationships with his mother and friends deteriorated significantly.

In June 2007, Toran severed ties with the psychiatrist and mental health services. Within a month he was back at school, he took this time to apologise to his mother and friends for his abusive behaviour and became free from the fatigue, agitation, anger and aggression he had experienced whilst under the influence of Prozac.

A year or so later Toran wanted to enroll in University but because of the time he missed from school [the period of "illness"] he was told that he would have to gain the credits to enroll in University, which meant he had to return to school.

Aeriel view of Takapuna Grammar School
Image: lernerlebnis.com

The Head of Takapuna Grammar, Toran's school, told him he was not welcome back due to Toran's previous behviour, absenteeism and lateness.

Now, for a head of a Grammar school to not fully understand the implications of taking psychiatric medication smacks of complete ignorance. Anyone will tell you that drugs such as SSRi's can make the patient tired and drowsy. Had the head have contacted the family GP he would have been told that Toran was sleeping for up to 18 hours a day! When Toran did make it to school, he was often late, for this he was punished with detention

His form tutor, Nick McMaster, also refused him access to his migraine medication despite his GP's requirement that he keep it at school and take it immediately should the onset of a migraine start.

Frustrated, Toran experienced a low mood but hope was at hand...or so he thought.

Amazingly, he and his mom were advised that there was a way for Toran to gain the credits needed for enrollment in University. What can only be described as sheer madness, both Toran and his mom were told that re-engagement with mental health services was the only option for Toran to receive teacher support by correspondence.

He decided that University was his goal so agreed to return to the mental health services for an assessment. Toran made it clear he did not want his former psychiatrist involved in his care.

The registrar who made the assessment recorded that Toran did not exhibit any indicators of depression but went ahead and prescribed him Prozac.

His mother, who by now had researched Prozac and had witnessed Toran's previous adverse reaction, objected vehemently but was told to to "stop reading research and trust his [psychiatrist's] professional judgement." The psychiatrist also refused to enter into any debate with Maria about talk therapy.

Toran was back under the influence of Prozac, the anger, agitation returned soon after he started ingesting it. Toran began drinking again and informed his psychiatrist whereupon he was told that it was okay to drink up to 6 bottles of beer on weekends provided he stop taking his Prozac on the Friday. The psychiatrist added that he could return to taking his Prozac once the weekend was over.

It should be mentioned at this point that Toran's psychiatrist, Zoran Simovik, was not fully qualified, he was, at the time, a psychiatric registrar.

I'm browsing through Prozac literature as I write this article and cannot see anything that states that it is okay to stop taking this medication abruptly... nor can I see any literature where it suggests that it is perfectly okay to consume alcohol. Quite what Simovik was thinking of here has me baffled. Surely even a psychiatric registrar would know the dangers of stopping an SSRi abruptly? It's basically cold turkey and although Prozac has a longer half life than most SSRi's, more than 48 hours without it could push even the mildest mannered of people over the edge.

Where did Simovik get his guidance from?

Why was Toran Henry assigned to an unqualified psychiatrist?

Speaking with Maria, here's what I learned:

Simovik’s psychiatric assessment of Toran was conducted in a busy public café with no privacy. It lasted 15 minutes.

In 2007 Toran had met with the cultural advisers from the unit where he was being seen. He told them he wanted them to set up a meeting with his dad who he hadn’t seen since he was 14 months old. The cultural advisers were male and female. The female cultural adviser, Rima Tiller, said that she knew Toran’s dad personally as her niece was pregnant to him. She promised to set up the meeting.

Let me get this straight. An employee from the unit had a niece who was pregnant by Toran's father,[now married] she then gave Toran assurances that she would set up a meeting between Toran and his father. Excuse me but isn't this a blatant conflict of interests?

So, Toran was left excited at the prospect of meeting with his father, a father whom he could not remember and one that he hadn't seen since he was 14 months old.

Toran's father, upon learning that his son and staff at the unit knew of his extra-marital affair, never showed up.

Toran was very angry and distressed that the promise to him had been broken and when he returned to mental health services in 2008 said that he wanted no contact with cultural services.

Maria told me:

"He was promised he would not have to see them. His first meeting there however, he walked out into the hall and the male cultural services worker, Sam Masui, was there. He tried to speak to Toran and when Toran ignored him, he began to yell at him and follow him as he tried to leave the building. I got in between them and told him to leave my son alone and when I got out to the car park, Toran was slumped over the bonnet of the car crying. His case worker, Tracy Reid, told me to get him in the car and get him out of there as the cultural services worker had followed us out to the car park and was still yelling at him. As a result of this, a decision was made that it was not safe for Toran to attend the mental health clinic (the cultural services worker was never disciplined or any action taken against him) and meetings should occur off site. This is why his psychiatric assessment was conducted in a café – a totally inappropriate venue for such an event."

With such a see-saw of emotions caused, in the main, by the very same people who were supposed to be caring for him and the medication he was taking, Toran began to distance himself from his mother and friends. He became lack-lustre, withdrawn - remember, all this whilst being on a medication that was supposed to help him not feel depressed.

Maria recounts a conversation with Toran in which he said he felt he had ‘super-adrenaline’ and had a sense he could achieve ‘superman-running.’ She believes this was Toran’s way of describing akathisia.

**Akathisia, or acathisia, is a syndrome characterized by unpleasant sensations of "inner" restlessness that manifests itself with an inability to sit still or remain motionless. [1]

This was one of the last 'sit down' conversations Maria Bradshaw had with her son.

Coming soon: Part II - The Loss

It is hoped that by telling Maria's story that other parents will come to realise the dangers of SSRi type medication.